Analysis of Factors Affecting the Development Status of Toddlers in Simomulyo Health Center Surabaya

How to Cite Dyah Aisyah Rachmawatie, Farida Fitriana, Martono Tri Utomo, Pudji Lestari/ Analysis of Factors Affecting the Development Status of Toddlers in Simomulyo Health Center Surabaya. Vol. 1, No. 6, March 2022 DOI https://doi.org/10.54543/kesans.v1i6.72 e-ISSN/p-ISSN 2808-7178 / 2808-7380 Publish by Rifa’Isntitute Analysis of Factors Affecting the Development Status of Toddlers in Simomulyo Health Center Surabaya


Introduction
Child development is one of the most important things for a child's future. The most crucial development occurs during the first five years of a child's life because it is a golden period. At this time all the development of the child must be by his age so that there are no developmental delays. A child's development can be influenced by several things, both internal and external factors. About 33% or 83 million Indonesians are children and will increase every year (Kemenkes RI, 2014). However, 5-10% of Indonesian children experience general developmental delays (Tjandrajani et al., 2016). Therefore, the development of Indonesian children deserves attention and has the right to achieve optimal development of both cognition, social, and emotional behavior. So that it takes good and appropriate guidance so that the development of children can achieve good quality. Prevention efforts as early as possible need to be done to reduce developmental problems with early detection. This early prevention examination can be done in Posyandu and can be done every three months in children aged 0-12 months and every six months in children aged 12-72 months (Kemenkes RI, 2014).
Based on data from the Surabaya City Health Office in 2017-2020, shows that in Simomulyo Subdistrict showed the largest prevalence of BBLR in Surabaya city in 2017 and increased continuously every year until 2020. And based on the Health Profile of Surabaya City in 2018, Simomulyo Health Center ranks first in cases of malnourished toddlers. By considering the factors related to the number of cases of BBLR and malnutrition in the working area of Simomulyo Health Center, then this study can be known the relationship of several factors related to the development status of toddlers in Simomulyo Health Center.

Research methods
This study uses an observational analytical research design with a case-control approach. This research was conducted at the Simomulyo Public Health Center, Surabaya City in August-November 2021. The dependent variable was developmental status. Independent variables were birth weight, nutritional status of children under five, parents' last education, economic status, history of disease in toddlers, and history of exclusive breastfeeding. In the study, the population was all children under five in the working area of the Simomulyo Health Center. Calculation of the sample using the sample formula to obtain the results of 100 samples.

Characteristics of Respondents
Based on the results of the study, the results showed that 100 respondents were 60% male and 40% female. With the distribution of age 0-24 months as much as 33%, age 24-36 months as much as 24%, and age 36-60 months as much as 43%. Of the 100 respondents, most or around 90% of toddlers with appropriate development, while 10% of toddlers with inappropriate development. As for 95% of toddlers with normal birth weight, the nutritional status is classified into 3 indicators, nutritional status based on BB/U with 1% undernourished under five categories, 3% undernourished toddlers category, 86% well-nourished toddlers category and 10% over-nourished toddlers, nutritional status based on TB/U with the category of very short toddlers 13%, short toddlers 7%, normal toddlers 45% and tall toddlers 35%, nutritional status based on BB/TB with very thin toddler categories 13%, underweight toddlers 5%, toddlers normal 64% and obese toddlers 18%. The distribution of the economic status of 100 parents of children under five in the working area of the Simomulyo Health Center is 18% of families with low economic status with an income of UMR in Surabaya, while the remaining 82% of families with middle and upper economic status with an income of UMR in Surabaya. Of the 100 toddlers who became respondents, the frequency of sick toddlers in the working area of the Simomulyo Health Center was balanced, with a frequency of 50 toddlers (50%) having a history of getting sick 2 times sick and 50 toddlers (50%) having a history of getting sick 2 times getting sick. Parents of children under five in the working area of the Simomulyo Health Center still have the responsibility to breastfeed their children, as evidenced by the percentage of exclusive breastfeeding for 6 months of 56% of 100 respondents.

Relationship between Birth Weight and Developmental Status
Based on  (Scharf et al., 2016) says that babies with low birth weight (BLR) will be more susceptible to infection so that it will indirectly inhibit the growth and development process. However, this study is in contrast to research (Linsell et al., 2015) which shows contradictory research results, which say that infants born with low birth weight (BLR) will be at risk of experiencing problems in their development. However, if given continuous stimulation can change these conditions. Toddlers with low birth weight still have the opportunity to develop optimally like toddlers in general.

Relationship between Nutritional Status and Developmental Status
Based on table 3, a bivariate analysis using the chi-square test showed that 90% of toddlers who experienced appropriate development were under five while 10% of toddlers experienced inappropriate developmental status. Furthermore, in the nutritional status table based on weight/age it is known that the p-value is 0.578, in the nutritional status table based on height/age it is known that the p-value is 0.375 and in the nutritional status table based on weight/height, it is known that the p-value is 0.706 where the value is 0.706. p> 0.05 which means that there is no relationship between nutritional status and developmental status of children under five.
Research conducted (Suharyanto et al., 2017) says that toddlers with abnormal nutritional status will experience inappropriate or hampered development due to inadequate nutrition, so cognitive development is far behind. In contrast to toddlers who get good nutrition. Likewise with research conducted by (Lindawati, 2012) where nutritional status is significantly related to the motor development of toddlers. Toddlers who are malnourished will potentially be 5 times at risk of developmental delays, resulting in development that is not by the age of the toddler.

Relationship of Parents' Last Education with Development Status
Based on table 4, a bivariate analysis using the chi-square test showed that 90% of toddlers who experienced appropriate development were under five while 10% of toddlers experienced inappropriate developmental status. Furthermore, in the table, it is known that the p-value is 0.488 and the OR (odds ratio) is 0.477, where the p-value is >0.05, which means that there is no relationship between the parents' last education and the developmental status of children under five.
Research conducted by (Rica Dini Lestari, 2016) states that mothers with a low level of education may find it difficult to receive various information and do not understand the needs of their children along with the stages of their developmental age. Likewise, research conducted (Warsito et al., 2012) where the higher the knowledge and capacity of parents in educating and caring for children, the higher the possibility of parents being able to provide stimulation or stimulation that can improve child development.

Relationship between Economic Status and Development Status
Based on table 5, a bivariate analysis using the chi-square test showed that 90% of toddlers who experienced appropriate development were under five while 10% of toddlers experienced inappropriate developmental status. Furthermore, in the table, it is known that the p-value is 0.103 and the OR (odds ratio) value is 0.201 where the p-value>0.05 which means that there is no relationship between economic status and the developmental status of children under five.
Families with a low economy, lacking in providing moral and educational values and lacking in helping children adapt and interact with society. In addition, families with low economic status often have limitations in stimulating abilities and stimulating the development of toddlers. So that indirectly economic status often greatly impacts the education and development of toddlers (Engle & Black, 2018).

Relationship between Child's Disease History and Developmental Status
Based on table 6, a bivariate analysis using the chi-square test showed that 90% of toddlers who experienced appropriate development were under five, while 10% of toddlers experienced inappropriate developmental status. Furthermore, in the table, it is known that the p-value is 0.046 and the OR (odds ratio) value is 4.57, where the p-value <0.05, which means that there is a relationship between the history of the child's illness and the developmental status of the toddler.
The results of this study are in line with research (Chung, 2014) where toddlers who have a history of illness, especially seizures in pain due to high fever will have a bad impact on their development because the effects of seizures can cause children to experience cognitive, motor and adaptive behavior disorders. In addition, if the child's disease history is not treated immediately, it will cause fatal complications in the future, because the child is likely to experience epilepsy, decreased level of consciousness, mental retardation, motor development disorders, and even death.

Relationship of Exclusive Breastfeeding History with Developmental Status
Based on table 7, a bivariate analysis using the chi-square test showed that 90% of toddlers who experienced appropriate development were under five while 10% of toddlers experienced inappropriate developmental status. Furthermore, in the table, it is known that the p-value is 0.002 and the OR (odds ratio) value is 14.1 where the p-value is <0.05, which means that there is a relationship between a history of exclusive breastfeeding and the developmental status of children under five.
Breast milk is proven to have many benefits, in addition to increasing the baby's immune system, breast milk can also improve children's eyesight, intelligence, and intelligence. Because it can increase the body's resistance, breast milk can reduce the risk of children getting a disease. It is proven that children who receive exclusive breastfeeding for 6 months or more have better motor skills than children who do not receive exclusive breastfeeding (Riyanti & Hanifah, 2014).

Conclusion
Based on the results of the research described above, it can be concluded that birth weight, nutritional status, parents' last education, economic status is not related to the developmental status of children under five. Meanwhile, from this study, the results of the analysis showed that a history of children's disease and a history of exclusive breastfeeding were related to the developmental status of children under five. These results are in line with research conducted by (Riyanti & Hanifah, 2014) that breast milk has many benefits, including increasing the child's immune system. So that children who are exclusively breastfed for 6 months have a lower risk of disease and have better motor skills than children who do not receive exclusive breastfeeding. And in a study conducted by (Chung, 2014) where children who have a history of illness, especially seizures caused by fever, have poor developmental abilities, because of the effects of seizures that are not treated immediately.